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To Work the Night Shift or Not? Unraveling the Link Between Sleep Disruption and Cancer


Sleep is a critical biological process influencing nearly every aspect of human health. While its role in physical and mental well-being is well-documented, the connection between sleep patterns and cancer risk has garnered increasing attention in recent years. Findings have revealed that sleep disruptions, whether due to insufficient sleep, poor sleep quality, or circadian rhythm disturbances, are linked to various health issues, including an elevated risk of developing cancer.

Sleep Deprivation and Cancer Risk          

Chronic sleep deprivation refers to the case of getting insufficient sleep or experiencing sleeplessness over an extended period(1). A growing body of evidence suggests that maintaining short sleep durations is linked to a higher incidence of cancers, particularly breast(2), colorectal(3, 4), and prostate cancer (5). For instance, a study by Zhao and colleagues(6) discovered that individuals who consistently sleep less than six hours per night have a 12% higher risk of developing cancer compared to those who get adequate sleep (7-8 hours per night). The underlying mechanisms involve disrupting the body’s hormonal balance, particularly that of melatonin—a hormone produced during sleep with antioxidant properties that regulate cell proliferation(7). In addition to regulating circadian rhythms and promoting cancer cell death, melatonin boosts immune cell survival and metabolism, which may enhance immune function against malignancies(8).

Circadian Rhythm Disruption and Cancer

Circadian rhythms are the body's internal clock that regulates the sleep-wake cycle, but they are not just about sleep. They are crucial in maintaining cellular processes and homeostasis. Disruptions in circadian rhythms, often seen in shift workers or people with irregular sleep patterns, have been linked to an increased cancer risk. Studies have shown that interferences in circadian rhythm can lead to dysregulation of genes involved in cell cycle control, DNA repair, and apoptosis, which are critical in preventing cancer development(9).

Another compelling piece of evidence comes from a working group of scientists that evaluated the carcinogenicity of night shift work. The Working Group rated night shift work as "probably carcinogenic to humans" due to minimal evidence of cancer in humans, substantial evidence of cancer in animals, and good mechanistic evidence in experimental animals. They categorized night shift work that involves circadian rhythm disruption as a probable Class 2A carcinogen (10). This classification underscores the significant role of maintaining circadian rhythm integrity in cancer prevention, motivating us to take proactive steps in our sleep habits.

Furthermore, disruption of the circadian-regulated sleep-wake cycle, as seen in night and shift workers, results in sleep deprivation, leading to impaired immune surveillance and metabolic imbalance. This disruption increases the likelihood of obesity and chronic low-grade inflammation, generating reactive oxygen species that damage cells and DNA, thereby heightening the risk of cancer (11).

Sleep Quality and Immune Function

Poor sleep quality, characterized by frequent awakenings, difficulty falling asleep, or non-restorative sleep, has also been implicated in cancer risk. Sleep disturbances can weaken the immune system, making the body more susceptible to the initiation and progression of cancer. A weakened immune response may reduce the body’s ability to detect and destroy malignant cells before they become tumors (12).

Moreover, poor sleep is associated with chronic inflammation, which is a known hallmark of cancer. Findings have revealed that sleep disturbance is positively associated with increased proinflammatory markers in adult cancer patients (13). Inflammation can also create an environment conducive to tumor growth by promoting cell proliferation, angiogenesis, and metastasis(14). Furthermore, another study revealed that sleep deprivation weakens immune surveillance and promotes immunosuppression in the tumor microenvironment, driving the progression of hepatocellular carcinoma(15).

Overall, the current and ongoing findings concede that maintaining good sleep hygiene could be a simple yet powerful strategy in cancer prevention and improving overall health.

Conclusion

The connection between sleep and cancer is an evolving area of research that highlights the importance of adequate and quality sleep in cancer prevention. Disruptions in sleep patterns and circadian rhythms affect general well-being and increase the risk of cancer development through various biological pathways. As our understanding deepens, integrating sleep health into cancer prevention strategies may become essential to public health initiatives.

References

1.           Bandyopadhyay A, Sigua NL. What Is Sleep Deprivation? Am J Respir Crit Care Med. Mar 15 2019;199(6):P11-P12. doi:10.1164/rccm.1996P11

2.           Kakizaki M, Kuriyama S, Sone T, et al. Sleep duration and the risk of breast cancer: the Ohsaki Cohort Study. Br J Cancer. Nov 04 2008;99(9):1502-5. doi:10.1038/sj.bjc.6604684

3.           Liu W, Zhang H. Do sleep quality and psychological factors link precancerous conditions of colorectal cancer? A retrospective case-control study. Expert Rev Gastroenterol Hepatol. Feb 2022;16(2):173-179. doi:10.1080/17474124.2022.2029701

4.           Thompson CL, Larkin EK, Patel S, Berger NA, Redline S, Li L. Short duration of sleep increases risk of colorectal adenoma. Cancer. Feb 15 2011;117(4):841-7. doi:10.1002/cncr.25507

5.           Cordina-Duverger E, Cénée S, Trétarre B, et al. Sleep Patterns and Risk of Prostate Cancer: A Population-Based Case Control Study in France (EPICAP). Cancer Epidemiol Biomarkers Prev. Nov 02 2022;31(11):2070-2078. doi:10.1158/1055-9965.EPI-22-0302

6.           Zhao H, Yin JY, Yang WS, et al. Sleep duration and cancer risk: a systematic review and meta-analysis of prospective studies. Asian Pac J Cancer Prev. 2013;14(12):7509-15. doi:10.7314/apjcp.2013.14.12.7509

7.           Moradkhani F, Moloudizargari M, Fallah M, Asghari N, Heidari Khoei H, Asghari MH. Immunoregulatory role of melatonin in cancer. J Cell Physiol. Feb 2020;235(2):745-757. doi:10.1002/jcp.29036

8.           Socaciu AI, Ionuţ R, Socaciu MA, et al. Melatonin, an ubiquitous metabolic regulator: functions, mechanisms and effects on circadian disruption and degenerative diseases. Rev Endocr Metab Disord. Dec 2020;21(4):465-478. doi:10.1007/s11154-020-09570-9

9.           Papagiannakopoulos T, Bauer MR, Davidson SM, et al. Circadian Rhythm Disruption Promotes Lung Tumorigenesis. Cell Metab. Aug 09 2016;24(2):324-31. doi:10.1016/j.cmet.2016.07.001

10.         group IMV. Carcinogenicity of night shift work. Lancet Oncol. Aug 2019;20(8):1058-1059. doi:10.1016/S1470-2045(19)30455-3

11.          Haus EL, Smolensky MH. Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation. Sleep Med Rev. Aug 2013;17(4):273-84. doi:10.1016/j.smrv.2012.08.003

12.         Blask DE. Melatonin, sleep disturbance and cancer risk. Sleep Med Rev. Aug 2009;13(4):257-64. doi:10.1016/j.smrv.2008.07.007

13.         Tong HH, Li JR, Feng Y, Li SW, Qiu H, Hong JF. The Association Between Sleep Disturbance and Proinflammatory Markers in Patients With Cancer: A Meta-analysis. Cancer Nurs. 2023 Mar-Apr 01 2023;46(2):E91-E98. doi:10.1097/NCC.0000000000001055

14.         Greten FR, Grivennikov SI. Inflammation and Cancer: Triggers, Mechanisms, and Consequences. Immunity. Jul 16 2019;51(1):27-41. doi:10.1016/j.immuni.2019.06.025

15.         Huang J, Song P, Hang K, et al. Sleep Deprivation Disturbs Immune Surveillance and Promotes the Progression of Hepatocellular Carcinoma. Front Immunol. 2021;12:727959. doi:10.3389/fimmu.2021.727959


Assessed and Endorsed by the MedReport Medical Review Board

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